_______________________________________________________________________________________________________________________________ 38 http://www.mjms.mk/ http://www.id-press.eu/mjms/ ID Design 2012/DOOEL Skopje, Republic of Macedonia Open Access Macedonian Journal of Medical Sciences. 2016 Mar 15; 4(1):38-42. http://dx.doi.org/10.3889/oamjms.2016.004 eISSN: 1857-9655 Clinical Science Fractional Carbon Dioxide Laser in Treatment of Acne Scars Andrej Petrov * , Vesna Pljakovska Acibadem Sistina Clinical Hospital, Skopje, Republic of Macedonia Citation: Petrov A, Pljakovska V. Fractional Carbon Dioxide Laser in Treatment of Acne Scars. Open Access Maced J Med Sci. 2016 Mar 15; 4(1):38-42. http://dx.doi.org/10.3889/oamjms.2016.004 Keywords: Acne scars; aesthetic dermatology; carbon dioxide laser systems; subjective evaluation of adverse effects by the therapy; scale of satisfaction by the treatment. * Correspondence: Dr. Andrej Petrov. Acibadem Sistina Clinical Hospital, Skopje, Republic of Macedonia. E-Mail: andrej.petrov@acibademsistina.mk Received: 15-Nov-2015; Revised: 16-Dec-2015; Accepted: 19-Dec-2015; Online first: 21-Dec-2015 Copyright: © 2016 Andrej Petrov, Vesna Pljakovska. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Competing Interests: The authors have declared that no competing interests exist. Abstract BACKGROUND: Scars appear as a result of skin damage during the process of the skin healing. There are two types of acne scars, depending on whether there is a loss or accumulation of collagen: atrophic and hypertrophic. In 80-90% it comes to scars with loss of collagen compared to smaller number of hypertrophic scars and keloids. AIM: The aim of the study was to determine efficiency and safety of fractional carbon dioxide laser in the treatment of acne scars. MATERIAL AND METHODS: The study was carried out in Acibadem Sistina Clinical Hospital, Skopje at the Department of Dermatovenerology, with a total of 40 patients treated with fractional carbon dioxide laser (Lutronic eCO2). The study included patients with residual acne scars of a different type. RESULTS: Comedogenic and papular acne in our material were proportionately presented in 50% of cases, while the other half were the more severe clinical forms of acne - pustular inflammatory acne and nodulocystic acne that leave residual lesions in the form of second, third and fourth grade of scars. CONCLUSION: The experiences of our work confirm the world experiences that the best result with this method is achieved in dotted ice pick or V-shaped acne scars. Introduction Acne is a common disease. Acne has a prevalence of 90% in adolescents and persists to adulthood in approximately 12-14% of cases, with serious psychological and social implications. Scars appear as a result of skin damage during the process of the skin healing. There are two types of acne scars, depending on whether there is a loss or accumulation of collagen: atrophic and hypertrophic. In 80-90% it comes to scars with loss of collagen compared to smaller number of hypertrophic scars and keloids. Atrophic scars are classified into ice pick, rolling and boxcar type. Dotted, ice pick represents 65-70% of atrophic scars, rolling type 20-30% and boxcar type 15-25%. Ice pick scars are narrow (2 mm), dotted and deep scars, with a wide opening and a deep infundibulum in the form of the letter V. Rolling scars are wider (up to 5mm) and they reach to the subcutaneous adipose tissue. They give a distorted appearance to the skin, in the form of the letter M. Boxcar scars have clearly visible vertical edges; they are wider than ice pick scars and take U shape with a broad and visible base [1]. Qualitative scarring gradation is applied according to Goodman and Baron [2] The first grade consists of macular hyper- and hypopigmentations that are visible. The second grade includes mild atrophy or hypertrophy, but can be concealed with cosmetics. The third grade consists of moderate atrophic or hypertrophic acne that can not easily be concealed with makeup and can be visible at